Ask Dr. Z

Could you help to clarify the use of modifier -Q0 in certain circumstances? Let’s assume the patient had the original acid placed for primary prevention and is coming in because the acid is at the end of life and the dx v53.32 is coded on chart. If patient comes in to have only the generator replaced, do you add modifier -Q0 to codes 33262-33264? If patient comes in to have a lead replaced to the existing generator, is modifier -Q0 added to code 33224? If the total system is replaced or upgraded, do you add modifier -Q0 to the CPT codes? Or are the above examples considered secondary intervention and modifier -Q0 not assigned because you have a qualifying dx on the claim (V53.32)?